Individual
AMANDA LISETTE BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 SOUTHWOOD PARK DR APT 54, HILTON HEAD ISLAND, SC 29926-2476
(843) 304-2242
Mailing address
11 SOUTHWOOD PARK DR APT 54, HILTON HEAD ISLAND, SC 29926-2476
(843) 304-2242
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11915
SC
Other
Enumeration date
06/12/2026
Last updated
06/12/2026
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